Individual
CHAD LAKE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
5680 E SAGINAW HWY, SUITE C, GRAND LEDGE, MI 48837-8102
(517) 622-8552
(517) 622-8591
Mailing address
5680 E SAGINAW HWY, SUITE C, GRAND LEDGE, MI 48837-8102
(517) 622-8552
(517) 622-8591
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2301008249
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4320240
—
MI
Enumeration date
08/23/2005
Last updated
07/09/2007
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